Cancer of unknown primary origin natural history, complications and prognosis: Difference between revisions
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==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
*Early clinical features include fatigue, weight-loss, and loss of appetite. | |||
* | *Cancers of unknown primary origin are characterized by their aggressiveness, early dissemination, and unpredictable metastasis. | ||
*The | *Upon presentation, around 60% of patients with cancer of unknown primary have two or more affected sites.<ref name="pmid8201389" /> | ||
*If left untreated, | *The most common sites of metastasis in cancer of unknown origin are [[lymph nodes]], [[lungs]], [[liver]], [[bones]], and [[pleura]].<ref name="pmid3046543">{{cite journal| author=Le Chevalier T, Cvitkovic E, Caille P, Harvey J, Contesso G, Spielmann M et al.| title=Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients. | journal=Arch Intern Med | year= 1988 | volume= 148 | issue= 9 | pages= 2035-9 | pmid=3046543 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3046543 }} </ref> | ||
*If left untreated, the majority of patients with [[cancer]] of unknown primary origin may progress to develop [[Multiple organ failure|multiple organ failure,]] [[heart failure]], and death. | |||
*Common [[complications]] of cancer of unknown primary origin, may include: [[hypercalcemia]], [[adrenal insufficiency]], and [[Siadh|inappropriate antidiuretic syndrome]], [[Hematologic diseases|hematologic disorders]], and malignant effusions. | |||
*Prognosis is generally poor, and the average survival time of patients with cancer of unknown primary origin is approximately 6-12 months after diagnosis.<ref name="pmid10697020">{{cite journal |vauthors=Nelson KA, Walsh D, Abdullah O, McDonnell F, Homsi J, Komurcu S, LeGrand SB, Zhukovsky DS |title=Common complications of advanced cancer |journal=Semin. Oncol. |volume=27 |issue=1 |pages=34–44 |year=2000 |pmid=10697020 |doi= |url=}}</ref><ref name="pmid3940611">{{cite journal| author=Altman E, Cadman E| title=An analysis of 1539 patients with cancer of unknown primary site. | journal=Cancer | year= 1986 | volume= 57 | issue= 1 | pages= 120-4 | pmid=3940611 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3940611 }} </ref> | |||
*Sites of [[metastasis]] and prognosis differ with the types of CUPs:<ref name="pmid10653878" /><ref name="pmid2451881">{{cite journal| author=Hainsworth JD, Dial TW, Greco FA| title=Curative combination chemotherapy for patients with advanced poorly differentiated carcinoma of unknown primary site. | journal=Am J Clin Oncol | year= 1988 | volume= 11 | issue= 2 | pages= 138-45 | pmid=2451881 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2451881 }} </ref><ref name="pmid8125789">{{cite journal| author=Nguyen C, Shenouda G, Black MJ, Vuong T, Donath D, Yassa M| title=Metastatic squamous cell carcinoma to cervical lymph nodes from unknown primary mucosal sites. | journal=Head Neck | year= 1994 | volume= 16 | issue= 1 | pages= 58-63 | pmid=8125789 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8125789 }} </ref><ref name="pmid7804965">{{cite journal| author=Kuttesch JF, Parham DM, Kaste SC, Rao BN, Douglass EC, Pratt CB| title=Embryonal malignancies of unknown primary origin in children. | journal=Cancer | year= 1995 | volume= 75 | issue= 1 | pages= 115-21 | pmid=7804965 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7804965 }} </ref> | |||
=== | {| class="wikitable" | ||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Type | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Common sites of metastasis | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Characteristics | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |5-year survival rates | |||
|- | |||
=== | | style="background:#DCDCDC;" align="center" + |[[Adenocarcinoma]] | ||
| style="background:#F5F5F5;" align="center" + |Liver, lungs, bones, axillary lymph nodes, and peritnoneum | |||
| style="background:#F5F5F5;" align="center" + |Most common type of CUP | |||
| style="background:#F5F5F5;" align="center" + |5% | |||
|- | |||
| style="background:#DCDCDC;" align="center" + |[[Squamous cell carcinoma]] | |||
| style="background:#F5F5F5;" align="center" + |Cervical lymph nodes | |||
| style="background:#F5F5F5;" align="center" + |More common in males | |||
| style="background:#F5F5F5;" align="center" + |30% | |||
|- | |||
| style="background:#DCDCDC;" align="center" + |[[Neuroendocrine tumor|Neuroendocrine carcinoma]] | |||
| style="background:#F5F5F5;" align="center" + |Bone marrow, bone lesions, lymph nodes, and lungs | |||
| style="background:#F5F5F5;" align="center" + |Predominating type in children | |||
| style="background:#F5F5F5;" align="center" + |17% | |||
|- | |||
| style="background:#DCDCDC;" align="center" + |Undifferntiated | |||
| style="background:#F5F5F5;" align="center" + |Lungs and lymph nodes | |||
| style="background:#F5F5F5;" align="center" + |Rapid tumor growth | |||
| style="background:#F5F5F5;" align="center" + |13-16% | |||
|} | |||
==References== | ==References== | ||
Revision as of 17:46, 5 February 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
- Early clinical features include fatigue, weight-loss, and loss of appetite.
- Cancers of unknown primary origin are characterized by their aggressiveness, early dissemination, and unpredictable metastasis.
- Upon presentation, around 60% of patients with cancer of unknown primary have two or more affected sites.[1]
- The most common sites of metastasis in cancer of unknown origin are lymph nodes, lungs, liver, bones, and pleura.[2]
- If left untreated, the majority of patients with cancer of unknown primary origin may progress to develop multiple organ failure, heart failure, and death.
- Common complications of cancer of unknown primary origin, may include: hypercalcemia, adrenal insufficiency, and inappropriate antidiuretic syndrome, hematologic disorders, and malignant effusions.
- Prognosis is generally poor, and the average survival time of patients with cancer of unknown primary origin is approximately 6-12 months after diagnosis.[3][4]
- Sites of metastasis and prognosis differ with the types of CUPs:[5][6][7][8]
| Type | Common sites of metastasis | Characteristics | 5-year survival rates |
|---|---|---|---|
| Adenocarcinoma | Liver, lungs, bones, axillary lymph nodes, and peritnoneum | Most common type of CUP | 5% |
| Squamous cell carcinoma | Cervical lymph nodes | More common in males | 30% |
| Neuroendocrine carcinoma | Bone marrow, bone lesions, lymph nodes, and lungs | Predominating type in children | 17% |
| Undifferntiated | Lungs and lymph nodes | Rapid tumor growth | 13-16% |
References
- ↑
- ↑ Le Chevalier T, Cvitkovic E, Caille P, Harvey J, Contesso G, Spielmann M; et al. (1988). "Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients". Arch Intern Med. 148 (9): 2035–9. PMID 3046543.
- ↑ Nelson KA, Walsh D, Abdullah O, McDonnell F, Homsi J, Komurcu S, LeGrand SB, Zhukovsky DS (2000). "Common complications of advanced cancer". Semin. Oncol. 27 (1): 34–44. PMID 10697020.
- ↑ Altman E, Cadman E (1986). "An analysis of 1539 patients with cancer of unknown primary site". Cancer. 57 (1): 120–4. PMID 3940611.
- ↑
- ↑ Hainsworth JD, Dial TW, Greco FA (1988). "Curative combination chemotherapy for patients with advanced poorly differentiated carcinoma of unknown primary site". Am J Clin Oncol. 11 (2): 138–45. PMID 2451881.
- ↑ Nguyen C, Shenouda G, Black MJ, Vuong T, Donath D, Yassa M (1994). "Metastatic squamous cell carcinoma to cervical lymph nodes from unknown primary mucosal sites". Head Neck. 16 (1): 58–63. PMID 8125789.
- ↑ Kuttesch JF, Parham DM, Kaste SC, Rao BN, Douglass EC, Pratt CB (1995). "Embryonal malignancies of unknown primary origin in children". Cancer. 75 (1): 115–21. PMID 7804965.